实用医学杂志 ›› 2021, Vol. 37 ›› Issue (22): 2903-2907.doi: 10.3969/j.issn.1006⁃5725.2021.22.015

• 药物与临床 • 上一篇    下一篇

经皮冠状动脉介入术后1年应用低剂量替格瑞洛的可行性及安全性研究

江小杰 刘丽赟 樊瀛丽   

  1. 南昌市第一医院心内一科(南昌330008)

  • 出版日期:2021-11-25 发布日期:2021-11-25
  • 通讯作者: 刘丽赟 E⁃mail:1098367330@qq.com
  • 基金资助:
    江西省卫生健康委科技计划(编号:202040008)

Feasibility and safety of low ⁃dose ticagrelor in patients with percutaneous coronary intervention after 12 months

JIANG Xiaojie,LIU Liyun,FAN Yingli.   

  1. First Department of Cardiology,the First Hospital of Nanchang City,Nanchang 330008,China

  • Online:2021-11-25 Published:2021-11-25
  • Contact: LIU Liyun E⁃mail:1098367330@qq.com

摘要:

目的 探讨急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)后1年应用低剂量替格瑞 洛的可行性及安全性。方法 连续入选2017年1月至2019年6月在我院PCI术后1年的ACS患者,根据抗 血小板策略的不同随机分为三组:阿司匹林组(100 mg、每日1次);替格瑞洛组(90 mg、每日2次)以及低剂 量替格瑞洛组(60 mg、每日2次)。随访24月中,比较三组患者的心血管的复合终点事件(MACE)以及所有出血事件,并检测患者的血小板聚集率。结果 随访过程中,三组患者MACE的发生率比较,差异均无统计学 意义(P>0.05)。和标准剂量替格瑞洛及阿司匹林相比,小剂量替格瑞洛组 BARC1 型出血有降低趋势,差 异有统计学意义(P = 0.002);在BARC1型以上出血风险中,三组间无统计学意义(P>0.05)。两组患者血小板 聚集率在各个随访时间相比较差异无统计学意义(P>0.05)。结论 在PCI术后1年的抗血小板药物选择中, 低剂量替格瑞洛可有效降低出血事件发生率,且不影响抗血小板聚集效果。

关键词:

冠心病, 皮冠状动脉介入术, 低剂量, 替格瑞洛

Abstract:

Objective To investigate the feasibility and safety of low⁃dose ticagrelor in acute coronary syn⁃ drome with percutaneous coronary intervention after 12months. Methods The acute coronary syndrome patients who underwent PCI in our hospital after 1 year from January 2017 to June 2019 were enrolled and randomly divided into three groups according to different antiplatelet strategies:Aspirin group(100 mg,once a day),Ticagrelor group(90mg twice daily)and Low⁃dose ticagrelor group(60 mg,twice daily). At a follow⁃up of 24 months,the Major Adverse Cardiovascular Events(MACCE)and all bleeding events were compared among the three groups and platelet aggregation rates were measured. Results During the follow⁃up,there was no statistical significance in the incidence of MACCE among 3 groups(P > 0.05). Compared with the Aspirin group and Ticagrelor group the Low⁃dose ticagrelor group had a decreasing trend of BARC1 hemorrhage,and the difference was statistically significant(P = 0.002). There was no statistical significance in the risk of bleeding above BARC1 among the three groups(P > 0.05). There was no statistical significance in platelet aggregation rate between 2 groups at each follow⁃ up time(P > 0.05). Conclusions After 1year,in the selection of antiplatelet agents in acute coronary syndrome with PCI,low⁃dose ticagrelor can effectively reduce the incidence of bleeding events without affecting the antiplatelet aggregation effect.

Key words:

coronary heart disease, percutaneous coronary intervention, low dose, Ticagrelor